Neurological, musculoskeletal, muscular, rheumatic, motor and/or cognitive diseases or injuries can cause great disruption in people's lives, incapacitating them from their daily activities, from simpler activities such as picking up an object, to more complex activities such as personal care and hygiene and handling equipment. Such diseases and injuries may impair a person's ability to function in everyday life.
In addition to injuries due to accidents, physical trauma, and degenerative diseases or strokes (CVA, cerebrovascular accidents), motor rehabilitation may also be necessary after surgeries, so that the patient may resume his/her regular activities.
To help patients' recovery, there is the one-on-one work of physiotherapists, who perform individual exercises for each patient, by using techniques developed in this field of human knowledge.
Although the work of these professionals may be important for patient rehabilitation, treatment, and recovery, physiotherapy sessions are usually time intensive, requiring the physiotherapist's physical participation, since he is executing the exercises along with the patient. With this, the patient's exercise time is limited to the duration of the session with the physiotherapist. Moreover, the exercises require the physiotherapist's own physical exertion, which will affect the quality of treatment. The physiotherapist, fatigued after several sessions, will not have the strength to execute exercises and movements in a consistent way with all patients.
Another disadvantage faced by the physiotherapist is that his ability to evaluate a patient's force, capacity of movement, and progress is highly subjective. In other words, where an evaluation or quantitative monitoring with objective numerical data is not possible, the result may be an inaccurate diagnosis and the prescription of insufficient treatment for a specific patient. Moreover, due to the subjectivity of the evaluation and monitoring, two or more physiotherapists may have diverging opinions.
In the attempt to aid a patient's motor rehabilitation and the physiotherapist's work, various types of equipment have been developed for motor rehabilitation of the upper and/or lower limbs, which are discussed below.
U.S. Pat. No. 8,177,688, for example, shows a large-size apparatus for the rehabilitation of lower limbs. It requires particular installations for its operation, which are difficult to transport and require the patient to remain standing while performing the exercises. Depending on the degree of the injury, it may even be necessary for the patient to be supported by straps, cords, and other devices.
U.S. Pat. No. 5,704,881 shows another large-size rehabilitation equipment where the patient is suspended by a set of cables.
U.S. Pat. No. 6,666,831 also shows a large-size equipment for the rehabilitation of lower limbs in which the patient is suspended by cables connected to his/her trunk, while each leg is connected to two mechanical rods that lift and lower the legs.
US Pat. App. No. 2015/0342817 shows a rehabilitation equipment for the lower limbs, which executes movements on the horizontal plane. In order to achieve the patient's rehabilitation the lower limb is positioned on a support.
Brazilian Patent PI 1000960-4 shows a rehabilitation equipment for the lower limbs in which the patient is suspended through cables and the lower limbs are moved upward and downward to reach motor rehabilitation.
Pat. App. Pub. WO 2014/085810 shows an apparatus for hand rehabilitation, which uses a spring system, pinion and rack gears and a motor to perform pronation and supination exercises or flexion and extension, one at a time, on a horizontal plane.
U.S. Pat. No. 7,367,958 shows an orthosis with an electromyographic sensor that is connected to the patient's arm and forearm, which is designed to stimulate the movement of the upper limb.
U.S. Pat. No. 5,951,499 shows an apparatus for the rehabilitation of the arm, forearm and hand, which performs only pronation and supination movements in the limb and takes a long time for the accommodation of the upper limb in the apparatus.
US Pat. App. No. 2016/0000633 shows a rehabilitation equipment that can execute exercises, one at a time, on a two-dimensional plane, by employing actuators, articulated arms, and a system that permits the movement of articulated arms to perform the rehabilitation exercises.
U.S. Pat. No. 5,466,213 shows a larger size apparatus directed toward the rehabilitation of the upper limbs composed of articulated arms that permit the execution of exercises, one at a time, on the two-dimensional plane. By this apparatus, the patient can perform separately flexion and extension exercises, after pronation and supination exercises, in addition to exercises with lateral movements. The size of the apparatus makes it difficult to transport.
U.S. Pat. No. 7,618,381 shows a rehabilitation apparatus for upper limbs that works with the patient's forearm and wrist set on a support or apparatus for the execution of exercises for the wrist. These exercises are performed on a two-dimensional plane. The part of the apparatus that exercises the wrist has three motors to perform its work and is connected to articulated arms linked to two motors for the execution of exercises for the rest of the upper limb, such that the patient's arm is also set on a support. Due to its characteristics, the apparatus has dimensions that make its transport difficult. The positioning of the patient's limb in the equipment takes a long time and the movements of the limbs are in the horizontal plane and with a support, performed one at a time.
Pat. App. Pub. WO 2014/057410 presents an exoskeleton for the rehabilitation and movement of lower limbs.
Pat. App. Pub. WO 2012/176200 shows a rehabilitation apparatus for the upper limbs which contains a sensor system, a mechanism of actuators and a data processing module to capture information about the healthy limb and to generate exercises for the member that requires rehabilitation.
Although the above may represent an advance in the motor rehabilitation of patients' upper or lower limbs, these apparatuses which represent the current state of the technology suffer from inconveniences and other disadvantages.
One of the disadvantages regards the size of the rehabilitation apparatuses, which have a large size, are difficult to be transported and need special locations to be prepared for their installation and their use. With such apparatuses, the patient must go to a facility where the apparatus is installed and therefore the execution of exercises is limited to the availability of this particular location's schedule, restricting the number of exercises that the patient can perform and increasing his/her time of recovery.
Another disadvantage is related to the time needed to position the patient's limb in the apparatus. As most apparatuses require the limb to be set on a support or device or the patient to be suspended by cables, a considerable time of the physiotherapy session is spent on the patient's positioning, which reduces the time of the exercises of the rehabilitation session.
It should be stated that the movements and exercises enabled by these apparatuses of the current state of the technology do not resemble the movements performed in daily life activities. This is because, during the exercises and movements, the patient's limb rests upon supports and devices or the patient is suspended by cables, which typically does not resemble daily life situations. Under normal conditions, people execute predominantly curvilinear movements in three-dimensional space.
These apparatuses are designed to perform the exercises one at a time without any integration of the movements, which, again, is dissimilar to movements that people perform in daily life.
Another disadvantage of the apparatuses of the current state of the technology is that they are made to perform exercises only on a horizontal plane, which generates a partial stimulus of the brain. This is because in the movement on a horizontal plane the force of gravity, which has vertical orientation and downward direction, does not influence the movement of the limb. This partial stimulation results in a longer and less effective rehabilitation for the patient.
A small amount of equipment pertaining to the current state of the technology uses software programs integrated to the apparatus in order to interact with the patient during the execution of exercises. These software programs, however, do not sufficiently stimulate and motivate the patient because they only show the point of origin and the point of destination of the movement, without any virtual setting to contextualize the exercises and movements in the patient's daily life and without creating links and similarities to the person's daily life activities. Aside from this, the current software programs are not entertaining and do not have an auditory and visual design conducive to the patient's cognitive stimulation during the rehabilitation sessions.
The invention that is the object of this patent application was developed in a new, original and creative way to help in the motor rehabilitation of the upper and lower limbs, by employing an innovative solution, which extends the current knowledge and incorporates significant innovations in this field of human knowledge.
This apparatus can be used by patients with neurological, musculoskeletal, muscular, rheumatic, motor and/or cognitive diseases or injuries, such as patients who have suffered CVA (cerebrovascular accident or stroke) or who are in a more advanced stage of Parkinson's or Alzheimer's diseases or who have suffered accidents or physical traumas. It may also be used for patients in recovery after a surgery, for patients who are trying to correct or to learn movements again, and for preventative training designed to prevent the progression of these diseases.